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This Sheet is for                                                                Passengers

List #

Extracted information from List or Manifest at Port of Arrival

S.S.

Other page nums:

Sailing from

 

Arriving at

 

 

Date

 

Date

 

 

1

Line Number on List

 

 

 

 

 

2

Head-Tax Status

 

 

 

 

 

3

Name in Full

Family Name

 

 

 

 

 

Given Name

 

 

 

 

 

4

Age

Years/Months

 

 

 

 

 

5

Sex

 

 

 

 

 

6

Married/Single

 

 

 

 

 

7

Calling/Occupation

 

 

 

 

 

8

Able to:

Read - Lang.

 

 

 

 

 

Write

 

 

 

 

 

9

Nationality

 

 

 

 

 

10

Race or People

 

 

 

 

 

11

Last Perm. Residence

Country

 

 

 

 

 

City/Town

 

 

 

 

 

12

Name/address of relative/friend in home country.

   

 

 

 

13

Final Destination

State

 

 

 

 

 

City/Town

 

 

 

 

 

14

Line Number on List

 

 

 

 

 

15

Ticket to final destination?

 

 

 

 

 

16

Who paid passage?

 

 

 

 

 

17

Have $50? If not how much?

 

 

 

 

 

18

Ever in US before?

 

 

 

 

 

If yes:

Year or period

 

 

 

 

 

Where?

 

 

 

 

 

19

Joining a relative or friend? Who and where?

 

 

 

 

  

20

Purpose of coming to US

Int. to return?

 

 

 

 

 

How long stay?

 

 

 

 

 

Int on US Citz?

 

 

 

 

 

21

Ever in prison, asylum, etc?

 

 

 

 

 

22

A polygamist?

 

 

 

 

 

23

An Anarchist?

 

 

 

 

 

24

Believe in overthrow of govt?

 

 

 

 

 

25

Come becaus of an offer?

 

 

 

 

 

26

Previosly deported?

 

 

 

 

 

27

Mental and Physical health

 

 

 

 

 

28

Deformed/crippled? Nature:

 

 

 

 

 

29

Height

Feet

 

 

 

 

 

Inches

 

 

 

 

 

30

Complexion

 

 

 

 

 

31

Color of

Hair

 

 

 

 

 

Eyes

 

 

 

 

 

32

Marks of Identification

 

 

 

 

 

33

Place of birth

Country

 

 

 

 

 

City/Town

 

 

 

 

 

Source info:

Extracted by:

Extract date:

 

 

Title of microfilm publication

NARA pub.number

Publisher

Microfilm roll #

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PIP Chapter 1, 2003 ~ Webmaster:  LPRoots@yahoo.com  ~  page last updated on Wednesday, January 24, 2007